OBJECTIVES: To determine the costs of treatment and the duration of survival, adjusted for quality of life, for patients with muscle-invasive bladder cancer treated with immediate radical cystectomy (RC) or with neoadjuvant chemotherapy (NAC) with intent for subsequent RC. METHODS AND MATERIALS: A retrospective review of our institutional review board-approved database identified patients with muscle-invasive bladder cancer treated at our institution from 2004 to 2011. Patients were divided into those receiving RC alone and those receiving NAC before planned RC. Patients who refused RC following NAC were included in an intention-to-treat analysis. Survival duration was converted to quality-adjusted life years (QALYs), and costs of treatment per QALY were determined. RESULTS: A total of 119 patients (65.4%) received RC alone and 63 (34.6%) received NAC, 38 of whom proceeded to cystectomy as planned. Mean total costs were $42,890 and $52,429 for RC and NAC, respectively (P = 0.005). The 5-year overall survival was 31.7% and 42.5% for the RC-only group and the NAC group, respectively (P = 0.034). The 5-year overall survival measured in QALYs was 21.9% and 42.9% for the RC-only and the NAC groups, respectively (P = 0.021). The increased cost for NAC was $5,840 per additional life year gained (95% CI: $1,772-$9,909) and $6,187 per additional QALY gained (95% CI: $1,877-$10,498). CONCLUSIONS: The use of NAC is associated with a significant increase in quality-adjusted survival. The additional cost per QALY gained is approximately $6,000. The cost-utility analysis of NAC compares favorably with other cancer-specific therapies.
OBJECTIVES: To determine the costs of treatment and the duration of survival, adjusted for quality of life, for patients with muscle-invasive bladder cancer treated with immediate radical cystectomy (RC) or with neoadjuvant chemotherapy (NAC) with intent for subsequent RC. METHODS AND MATERIALS: A retrospective review of our institutional review board-approved database identified patients with muscle-invasive bladder cancer treated at our institution from 2004 to 2011. Patients were divided into those receiving RC alone and those receiving NAC before planned RC. Patients who refused RC following NAC were included in an intention-to-treat analysis. Survival duration was converted to quality-adjusted life years (QALYs), and costs of treatment per QALY were determined. RESULTS: A total of 119 patients (65.4%) received RC alone and 63 (34.6%) received NAC, 38 of whom proceeded to cystectomy as planned. Mean total costs were $42,890 and $52,429 for RC and NAC, respectively (P = 0.005). The 5-year overall survival was 31.7% and 42.5% for the RC-only group and the NAC group, respectively (P = 0.034). The 5-year overall survival measured in QALYs was 21.9% and 42.9% for the RC-only and the NAC groups, respectively (P = 0.021). The increased cost for NAC was $5,840 per additional life year gained (95% CI: $1,772-$9,909) and $6,187 per additional QALY gained (95% CI: $1,877-$10,498). CONCLUSIONS: The use of NAC is associated with a significant increase in quality-adjusted survival. The additional cost per QALY gained is approximately $6,000. The cost-utility analysis of NAC compares favorably with other cancer-specific therapies.
Authors: S M Bartsch; J A McKinnell; L E Mueller; L G Miller; S K Gohil; S S Huang; B Y Lee Journal: Clin Microbiol Infect Date: 2016-09-15 Impact factor: 8.067
Authors: Ronald Kool; Ivan Yanev; Tarek Hijal; Marie Vanhuyse; Fabio L Cury; Luis Souhami; Wassim Kassouf; Alice Dragomir Journal: Can Urol Assoc J Date: 2022-06 Impact factor: 2.052
Authors: Diana Magee; Douglas Cheung; Amanda Hird; Srikala S Sridhar; Charles Catton; Peter Chung; Alejandro Berlin; Padraig Warde; Alexandre Zlotta; Neil Fleshner; Girish S Kulkarni Journal: Can Urol Assoc J Date: 2022-04 Impact factor: 2.052
Authors: Van T Nghiem; Riha Vaidya; Gary H Lyman; Dawn L Hershman; Scott D Ramsey; Joseph M Unger Journal: Value Health Date: 2020-10-09 Impact factor: 5.725
Authors: Andrew J Sutton; John V Lamont; R Mark Evans; Kate Williamson; Declan O'Rourke; Brian Duggan; Gurdeep S Sagoo; Cherith N Reid; Mark W Ruddock Journal: PLoS One Date: 2018-08-23 Impact factor: 3.240
Authors: Bruce Y Lee; Sarah M Bartsch; Marie C Ferguson; Patrick T Wedlock; Kelly J O'Shea; Sheryl S Siegmund; Sarah N Cox; James A McKinnell Journal: PLoS Comput Biol Date: 2021-01-07 Impact factor: 4.475
Authors: Ryan K Orosco; Viridiana J Tapia; Joseph A Califano; Bryan Clary; Ezra E W Cohen; Christopher Kane; Scott M Lippman; Karen Messer; Alfredo Molinolo; James D Murphy; John Pang; Assuntina Sacco; Kathryn R Tringale; Anne Wallace; Quyen T Nguyen Journal: Sci Rep Date: 2018-04-09 Impact factor: 4.379